What should I do? I think I goofed!!

[WinterGirlyRN]

Hi,

I'm a new RN with only 2 months of working solo under my belt. I think I goofed big time.

I had a pt last week who had a PRN order for Tylenol in suppository form. It had been order Rectally when he had previously had an NG tube and was NPO. So he developed a bit of a temp and he refused the rectal form and asked for PO. Heres my goof....I entered the order using the same MD who had ordered the rectal form without calling said doc.

How bad did I goof??

Why did I not call? Because the docs yell at me everytime I call them unless its for something urgent. I was having a bad night and coulldnt take another ticked off doc.

Help? Did I really screw up?

[queenjean]

posted by ruby vee:

"i work in an icu, and we're within our scope to do this -- but i'd tell the prescriber just as soon as i saw them. and you're right -- i could be in trouble, too, if the prescriber wanted to make trouble."

i just want to be sure i understand. do your policies actually support writing a doctor's order when you haven't spoken to a doctor in person or on the phone?

our hospital has protocols in place that allow for pharmacists to write equivalency substitutions; both medication wise (like nexium for a pepcid) or route (iv instead of po, or vice versa) under certain circumstances. the pharmacist can always refuse (for example, if i wanted to switch an iv abx to po) if they think it is a bad idea. in the tylenol situation, i would simply be able to call the pharmacist and request he/she write an equivalency substitution. it's a nice option to have.